Difference between Critical Care and High Dependency Care
Critical care is an umbrella term used to refer services that include Intensive Therapy Units (ITU) now referred to as Intensive Care Units (ICU), Operating Theatres, High Dependency Units (HDU), and Post Anaesthetic Care Units (PACU) also known as Recovery Rooms. It is usually accepted that high dependency is a level of care between a general ward and the Intensive Care Unit. The terms high dependency care and critical care can be, and often, are interchangeable. For the purpose of this study, the term used is high dependency care. The availability of high dependency care for pregnant women is essential to both the midwives and women. It is essential to prevent transferring women to a higher level of care including high dependency care without the justification and clinical need. Admission to intensive care unit is required by some of the women who experience clinical descent while other such women might require HDC. HDC is the level of care that lies between ordinary ward and intensive care unit and is considered as a way through which workload can be relieved in the intensive care units. HDC can be delivered to the women either at the HDC unit or in the maternity unit. There can be specifically allocated HDC units in the maternity wards, or there might be beds that are particularly allocated to HDC in the labour ward.
Healthcare professionals have positively evaluated the provision of HDC to bring together the requisite critical and obstetric care and promote the continuity of care to the pregnant women and also to their family. Identification of the number of women admitted to HDC units due to obstetric reasons has been performed by an increased body of evidence. It has been estimated that 0.9% of all the admissions that are made to the intensive care units in the UK are those of the obstetric patients. Contrary to this finding, there is a scarcity of data regarding the figure of pregnant women who need HDC.
There might be difficulties in the collection of data that could be attributed to the elimination of labour wards from the datasets of critical care and the deficiency of accurate definition of maternal HDC. According to the data collected in North Staffordshire over a decade ago, nearly 1% of the women were identified to have received maternal HDC. However, according to the data obtained from a vast tertiary obstetric unit in a recent study, maternal HDC was required by 5.1% of all the women.